Healthcare Provider Details

I. General information

NPI: 1821165119
Provider Name (Legal Business Name): DIANA SHKOLNIK L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2886 GEARY BLVD SUITE #204
SAN FRANCISCO CA
94118-3454
US

IV. Provider business mailing address

1647 42ND AVE
SAN FRANCISCO CA
94122-3043
US

V. Phone/Fax

Practice location:
  • Phone: 415-771-2389
  • Fax: 415-771-2389
Mailing address:
  • Phone: 415-665-1111
  • Fax: 415-665-1111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC7626
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: